Overview - Cholecystectomy (gallbladder removal) - Mayo Clinic Cholecystectomy (gallbladder removal) Print A cholecystectomy (koh-luh-sis-TEK-tuh-me) is a surgical procedure to remove your gallbladder — a pear-shaped organ that sits just below your liver on the upper right side of your abdomen. Your gallbladder collects and stores bile — a digestive fluid produced in your liver. A cholecystectomy may be necessary if you experience pain from gallstones that block the flow of bile. A cholecystectomy is a common surgery, and it carries only a small risk of complications. In most cases, you can go home the same day of your cholecystectomy. A cholecystectomy is most commonly performed by inserting a tiny video camera and special surgical tools through four small incisions to see inside your abdomen and remove the gallbladder. Doctors call this a laparoscopic cholecystectomy. In some cases, one large incision may be used to remove the gallbladder. This is called an open cholecystectomy. Gallstones. National Institute of Diabetes and Digestive and Kidney Diseases.

Accessed June 15, 2016. Understanding gallstones. American Gastroenterological Association. Accessed June 15, 2016. Feldman M, et al. Gallstone disease. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. Accessed June 16, 2016. Patient information for laparoscopic gall bladder removal (cholecystectomy) from SAGES. Society of American Gastrointestinal and Endoscopic Surgeons. Accessed June 15, 2016. Feldman M, et al. Gallstone disease. In: Sleisenger and Fordtran's Gastrointestinal Cholecystectomy. American College of Surgeons. Accessed June 15, 2016. Picco MF (expert opinion). Mayo Clinic, Rochester, Minn. June 22, 2016. Related Cholecystectomy | Johns Hopkins Medicine Health Library What is a cholecystectomy?

A cholecystectomy is surgery to remove your gallbladder. The gallbladder is a small organ under your liver. It is on the upper right side of your belly or abdomen. The gallbladder stores a digestive juice called bile which is made in the liver. There are 2 types of surgery to remove the gallbladder: Open (traditional) method. In this method, 1 cut (incision) about 4 to 6 inches long is made in the upper right-hand side of your belly. The surgeon finds the gallbladder and takes it out through the incision. Laparoscopic method. This method uses 3 to 4 very small incisions. It uses a long, thin tube called a laparoscope. The tube has a tiny video camera and surgical tools. The tube, camera and tools are put in through the incisions. The surgeon does the surgery while looking at a TV monitor. The gallbladder is removed through 1 of the incisions. A laparoscopic cholecystectomy is less invasive. That means it uses very small incisions in your belly. There is less bleeding. The recovery time is usually shorter than an open surgery.

In some cases the laparoscope may show that your gallbladder is very diseased. Or it may show other problems. Then the surgeon may have to use an open surgery method to remove your gallbladder safely. Why might I need a cholecystectomy? A cholecystectomy may be done if your gallbladder: Has lumps of solid material ( gallstones ) Is red or swollen (inflamed), or infected ( cholecystitis ) Is cancerous Gallbladder problems may cause pain which: Is usually on the right side or middle of your upper belly May be constant or may get worse after a heavy meal May sometimes feel more like fullness than pain May be felt in your back and in the tip of your right shoulder blade Other symptoms may include nausea, vomiting, fever, and chills. The symptoms of gallbladder problems may look like other health problems. Always see your healthcare provider to be sure. Your healthcare provider may have other reasons to recommend a cholecystectomy. What are the risks of a cholecystectomy?

Some possible complications of a cholecystectomy may include: Bleeding Infection Injury to the tube (the bile duct) that carries bile from the gallbladder to the small intestine Liver injury Scars and a numb feeling at the incision site A bulging of organ or tissue (a hernia) at the incision site During a laparoscopic procedure, surgical tools are put into your belly. This may hurt your intestines or blood vessels. You may have other risks that are unique to you. Be sure to discuss any concerns with your healthcare provider before the procedure. How do I get ready for a cholecystectomy? Your healthcare provider will explain the procedure to you. Ask him or her any questions you have. You may be asked to sign a consent form that gives permission for the procedure. Read the form carefully and ask questions if anything is not clear. Your provider will ask questions about your past health. He or she may also give you a physical exam. This is to make sure you are in good health before the procedure. You may also need blood tests and other diagnostic tests. You must not eat or drink for 8 hours before the procedure. This often means no food or drink after midnight.

Tell your provider if you are pregnant or think you may be pregnant. Tell your provider if you are sensitive to or allergic to any medicines, latex, tape, and anesthesia medicines (local and general). Tell your provider about all the medicines you take. This includes both over-the-counter and prescription medicines. It also includes vitamins, herbs, and other supplements. Tell your provider if you have a history of bleeding disorders. Let your provider know if you are taking any blood-thinning medicines, aspirin, ibuprofen, or other medicines that affect blood clotting. You may need to stop taking these medicines before the procedure. If this is an outpatient procedure, you will need to have someone drive you home afterward. You won’t be able to drive because of the medicine given to relax you before and during the procedure. Follow any other instructions your provider gives you to get ready. What happens during a cholecystectomy? You may have a cholecystectomy as an outpatient or as part of your stay in a hospital. The way the surgery is done may vary depending on your condition and your healthcare provider's practices. A cholecystectomy is generally done while you are given medicines to put you into a deep sleep (under general anesthesia).

Generally, a cholecystectomy follows this process: You will be asked to take off any jewelry or other objects that might interfere during surgery. You will be asked to remove clothing and be given a gown to wear. An intravenous (IV) line will be put in your arm or hand. You will be placed on your back on the operating table. The anesthesia will be started. A tube will be put down your throat to help you breathe. The anesthesiologist will check your heart rate, blood pressure, breathing, and blood oxygen level during the surgery. If there is a lot of hair at the surgical site, it may be clipped off. The skin over the surgical site will be cleaned with a sterile (antiseptic) solution. Open method cholecystectomy An incision will be made. The incision may slant under your ribs on the right side of your abdomen. Or it may be made in the upper part of your abdomen. Your gallbladder is removed. In some cases, 1 or more drains may be put into the incision. This allows drainage of fluids or pus. Laparoscopic method cholecystectomy About 3 or 4 small incisions will be made in your abdomen.

Carbon dioxide gas will be put into your abdomen so that it swells up. This lets the gallbladder and nearby organs be easily seen. The laparoscope will be put into an incision. Surgical tools will be put through the other incisions to remove your gallbladder. When the surgery is done, the laparoscope and tools are removed. The carbon dioxide gas is let out through the incisions. Most of it will be reabsorbed by your body. Procedure completion, both methods The gallbladder will be sent to a lab for testing The incisions will be closed with stitches or surgical staples A sterile bandage or dressing or adhesive strips will be used to cover the wounds What happens after a cholecystectomy? In the hospital After the procedure, you will be taken to the recovery room to be watched. Your recovery process will depend on the type of surgery and the type of anesthesia you had. Once your blood pressure, pulse, and breathing are stable and you are awake and alert, you will be taken to your hospital room. A laparoscopic cholecystectomy may be done on an outpatient basis. In this case, you may be discharged home from the recovery room. You will get pain medicine as needed.

A nurse may give it to you. Or you may give it to yourself through a device connected to your IV (intravenous) line. You may have a thin plastic tube that goes through your nose into your stomach. This is to remove air that you swallow. The tube will be taken out when your bowels are working normally. You won’t be able to eat or drink until the tube is removed. You may have 1 or more drains in the incision if an open procedure was done. The drains will be removed in a day or so. You might be discharged with the drain still in and covered with a dressing. Follow your provider’s instructions for taking care of it. You will be asked to get out of bed a few hours after a laparoscopic procedure or by the next day after an open procedure. Depending on your situation, you may be given liquids to drink a few hours after surgery. You will slowly be able to eat more solid foods as tolerated. Arrangements will be made for a follow-up visit with your provider. This is usually 2 to 3 weeks after surgery. At home Once you are home, it’s important to keep the incision clean and dry. Your provider will give you specific bathing instructions.

If stitches or surgical staples are used, they will be removed during a follow-up office visit. If adhesive strips are used, they should be kept dry and usually will fall off within a few days. The incision and your abdominal muscles may ache, especially after long periods of standing. If you had a laparoscopic surgery, you may feel pain from any carbon dioxide gas still in your belly. This pain may last for a few days. It should feel a bit better each day. Take a pain reliever as recommended by your provider. Aspirin or other pain medicines may raise your risk of bleeding. Be sure to take only medicines your healthcare provider has approved. Walking and limited movement are generally fine. But you should avoid strenuous activity. Your provider will tell you when you can return to work and go back to normal activities.

Call your provider if you have any of the following: Fever or chills Redness, swelling, bleeding, or other drainage from the incision site More pain around the incision site Yellowing of your skin or the whites of your eyes (jaundice) Belly or abdominal pain, cramping, or swelling No bowel movement or gas for 3 days Pain behind your breastbone Gallbladder removal - open: MedlinePlus Medical Encyclopedia Tell your doctor or nurse: If you are or might be pregnant Which drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription During the week before surgery: You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), vitamin E, warfarin (Coumadin), and any other drugs that may put you at a higher risk of bleeding during surgery. Ask your doctor which drugs you should still take on the day of your surgery. Prepare your home for any problems you might have getting around after the surgery. You'll be told when to arrive at the hospital. On the day of surgery: Follow instructions about when to stop eating and drinking. Take the drugs your doctor told you to take with a small sip of water.

Shower the night before or the morning of your surgery. Arrive at the hospital on time. After the Procedure You may stay in the hospital for 3 to 5 days after open gallbladder removal. During that time: You may be asked to breathe into a device called an incentive spirometer. This helps keep your lungs working well so that you do not get pneumonia. The nurse will help you sit up in bed, hang your legs over the side, and then stand up and start to walk. At first, you will receive fluids into your vein through an intravenous (IV) tube. Soon after, you will be asked to start drinking liquids and eating foods. You will be able to shower while you are still in the hospital. You may be asked to wear pressure stockings on your legs to help prevent a blood clot from forming. These stockings also help keep your blood circulating well. If there were problems during your surgery, or if you have bleeding, a lot of pain, or a fever, you may need to stay in the hospital longer. Your doctor or nurses will tell you how to care for yourself after you leave the hospital. Outlook (Prognosis) Most people recover quickly and have good results from this procedure.

Alternative Names Cholecystectomy - open; Surgery - gallbladder - open Images Lap Chole | Laparoscopic Surgery | MUSC DDC Laparoscopic Surgery For more information about cholecystectomy procedures at MUSC, call: Mary Johnson, RN Laparoscopic cholecystectomy, commonly referred to as a lap chole, involves the removal of the gallbladder through a laparoscopic approach. The gallbladder normally stores bile produced in the liver until it is needed for digestion. Unfortunately, the gallbladder often forms gallstones . Symptoms Many patients have gallstones which do not cause symptoms and require no surgery. If, however, these stones attempt to pass out of the gallbladder and block the gallbladder outlet, severe upper abdominal pain can develop. This is known as colic. Common symptoms may include: upper abdominal pain, occurring after meals rich in fat nausea and vomiting pain between the shoulder blades, and beneath the right shoulder chills and fever Symptoms usually last for short periods of time and often occurs after fatty meals which stimulate the gallbladder to contract.

Causes The formation of gallstones seems to be related to many factors, some of which are: body weight — over-weight people have a higher incidence of gallstones diet — a diet high in fat and cholesterol, and low in fiber gallbladder motility — if the gall bladder is slow to drain rapid weight loss — bariatric surgery patients experience higher incidences of gallstones Acute Cholecystitis Occasionally, these stones may become lodged within the neck of the gallbladder and result in prolonged episodes of pain associated with infection. This is known as acute cholecystitis and generally requires admission to hospital and cholecystectomy. Obstructive Jaundice Another complication of gallstones may be obstructive jaundice . In this situation, the gallstones pass out of the gallbladder and into the bile duct where they block the bile duct exit; that is, the gallstones prevent the flow of bile secretions into the duodenum . Jaundice is first recognized in the eyes, but acute jaundice results in a yellow tinge to the skin. This may result in cholangitis , a progressive form of jaundice and infections. This needs to be treated immediately.

Once a person has had one attack of gallstones, they are likely to develop more. It is thus wise to remove the gallbladder between attacks, since surgery is simpler when there is no acute infection or obstruction. Treatment In the operating room under general anesthesia, a small needle is inserted into the umbilicus (belly button) to allow inflation of the abdomen with gas. Next, a small hole (port) is created, also in the bellow button, followed by the insertion of a thin scope with a camera at its end to allow visualization within the abdominal cavity. A second port is placed just under the breast bone in the midline of the abdomen, while third and fourth ports are placed in the right side of the abdomen. (These allow for removal of the gallbladder later in the procedure.) The gallbladder is then freed of any scar tissue which may be present from previous episodes of acute cholecystitis. The cystic duct (the duct that joins the gallbladder to the bile duct) is then identified. Also identified is the cystic artery, a small blood vessel leading to the gallbladder.

A small incision is made either in the gallbladder itself or in the cystic duct to allow insertion of a small tube or catheter. Dye is injected through this catheter to allow visualization of the bile ducts and insure that no stones are present within the bile duct on an x-ray screen. If there are no stones present in the bile duct, the cystic duct is divided after sealing it with metallic clips. The cystic artery is then clipped and divided and the gallbladder is separated from the bed of the liver with a cautery device or laser. The gallbladder is then removed through one of the small incision ports. Finally, the ports are closed. If a stone is found in the common bile duct, most may also be removed during the laparoscopy. These stones can be flushed through the bile duct and into the bowel where they will pass without further problems. If they are not flushed easily, access to the bile duct can be gained through the cystic duct by dilating it up to a size big enough to allow passage of a small scope known as a choledochoscope. The choledochoscope allows doctors to see within the bile duct and the stones can be grasped with small baskets and removed.

Rarely, if the stones are impacted a small drain is left in place, and the stones are removed later at another procedure called ERCP . After waking up following a laparoscopic cholecystectomy, patients are usually able to eat right away. Also, patients are usually able to go home that very day or day following. Most patients return to normal activities within one to two weeks of their surgery. Complications Laparoscopic cholecystectomy has a complication rate of under two percent. It is a well-documented and frequently-performed procedure. Most patients recover and resume normal activities quickly. Rarely does the surgery impact adjacent organs in the body. When this occurs, a second procedure may be required. Give Us a Call Cholecystectomy | definition of cholecystectomy by Medical dictionary Cholecystectomy | definition of cholecystectomy by Medical dictionary Related to cholecystectomy: laparoscopic cholecystectomy , gallbladder Cholecystectomy Definition A cholecystectomy is the surgical removal of the gallbladder. The two basic types of this procedure are open cholecystectomy and the laparoscopic approach. It is estimated that the laparoscopic procedure is currently used for approximately 80% of cases.

Purpose A cholecystectomy is performed to treat cholelithiasis and cholecystitis . In cholelithiasis, gallstones of varying shapes and sizes form from the solid components of bile. The presence of stones, often referred to as gallbladder disease, may produce symptoms of excruciating right upper abdominal pain radiating to the right shoulder. The gallbladder may become the site of acute infection and inflammation, resulting in symptoms of upper right abdominal pain, nausea and vomiting . This condition is referred to as cholecystitis. The surgical removal of the gallbladder can provide relief of these symptoms. Precautions Although the laparoscopic procedure requires general anesthesia for about the same length of time as the open procedure, laparoscopy generally produces less postoperative pain, and a shorter recovery period. The laparoscopic procedure would not be preferred in cases where the gallbladder is so inflamed that it could rupture, or when adhesions (additional fibrous bands of tissue) are present.

Description The laparoscopic cholecystectomy involves the insertion of a long narrow cylindrical tube with a camera on the end, through an approximately 1 cm incision in the abdomen, which allows visualization of the internal organs and projection of this image onto a video monitor. Three smaller incisions allow for insertion of other instruments to perform the surgical procedure. A laser may be used for the incision and cautery (burning unwanted tissue to stop bleeding), in which case the procedure may be called laser laparoscopic cholecystectomy. In a conventional or open cholecystectomy, the gallbladder is removed through a surgical incision high in the right abdomen, just beneath the ribs. A drain may be inserted to prevent accumulation of fluid at the surgical site. Preparation As with any surgical procedure, the patient will be required to sign a consent form after the procedure is explained thoroughly. Food and fluids will be prohibited after midnight before the procedure. Enemas may be ordered to clean out the bowel.

If nausea or vomiting are present, a suction tube to empty the stomach may be used, and for laparoscopic procedures, a urinary drainage catheter will also be used to decrease the risk of accidental puncture of the stomach or bladder with insertion of the trocar (a sharp-pointed instrument). Aftercare Post-operative care for the patient who has had an open cholecystectomy, as with those who have had any major surgery, involves monitoring of blood pressure, pulse, respiration and temperature. Breathing tends to be shallow because of the effect of anesthesia, and the patient's reluctance to breathe deeply due to the pain caused by the proximity of the incision to the muscles used for respiration. The patient is shown how to support the operative site when breathing deeply and coughing, and given pain medication as necessary. Fluid intake and output is measured, and the operative site is observed for color and amount of wound drainage. Fluids are given intravenously for 24-48 hours, until the patient's diet is gradually advanced as bowel activity resumes. The patient is generally encouraged to walk 8 hours after surgery and discharged from the hospital within three to five days, with return to work approximately four to six weeks after the procedure.

Key terms Cholecystitis — Infection and inflammation of the gallbladder, causing severe pain and rigidity in the upper right abdomen. Cholelithiasis — Also known as gallstones, these hard masses are formed in the gallbladder or passages, and can cause severe upper right abdominal pain radiating to the right shoulder, as a result of blocked bile flow. Gallbladder — A hollow pear-shaped sac on the under surface of the right lobe of the liver. Bile comes to it from the liver, and passes from it to the intestine to aid in digestion. Care received immediately after laparoscopic cholecystectomy is similar to that of any patient undergoing surgery with general anesthesia. A unique post-operative pain may be experienced in the right shoulder related to pressure from carbon dioxide used through the laparoscopic tubes. This pain may be relieved by laying on the left side with right knee and thigh drawn up to the chest. Walking will also help increase the body's reabsorption of the gas. The patient is usually discharged the day after surgery, and allowed to shower on the second postoperative day. The patient is advised to gradually resume normal activities over a three day period, while avoiding heavy lifting for about 10 days.

Risks Potential problems associated with open cholecystectomy include respiratory problems related to location of the incision, wound infection, or abscess formation. Possible complications of laparoscopic cholecystectomy include accidental puncture of the bowel or bladder and uncontrolled bleeding. Incomplete reabsorption of the carbon dioxide gas could irritate the muscles used in respiration and cause respiratory distress. Resources Other "Gallstones and Laparoscopic Cholecystectomy." Centers for Disease Control and Prevention. 〈〉. "Patient Information Documents on Digestive Diseases." National Institute of Diabetes and Digestive and Kidney Disease. cholecystectomy [ko″le-sis-tek´to-me] excision of the gallbladder , usually done to relieve the symptoms of cholecystitis associated with gallstones . During the operation a dye may be injected directly into the biliary ducts and a cholangiogram done to determine whether there are any stones within the ducts. If stones are known or suspected to be in the common bile duct, a T-tube is inserted to bypass the calculi and allow drainage of bile. The end of the tube is brought to the outside through a stab wound in the upper right quadrant and attached to a drainage bag.

In spite of the intraoperative cholangiography, some patients will retain stones in the common bile duct after the surgery. laparoscopy is commonly used, which allows most patients to go home on the same day as surgery and return to full activity within a week. Patient Care. During the preoperative period the patient will be given a thorough physical examination as well as specific tests for liver function and either radiologic or endoscopic studies of the gallbladder and biliary drainage system. Because nausea and flatulence are common problems in these patients, a nasogastric tube usually is inserted and attached to a decompression apparatus prior to surgery. When the patient returns from surgery a careful check is made for drainage tubes inserted during the operation. Sometimes the drains are devised so that bile and serous fluid from the operative site drain directly onto the surgical dressings. Other drains or tubes such as a T-tube or Y-tube are attached to a drainage bag so that the amount of bile removed can be measured periodically. In either case, dressings over the wound are checked frequently for signs of bleeding or other abnormalities in the character and amount of drainage.

When bile leakage is copious, as it sometimes is, the dressings will need to be reinforced and the outer layers changed as often as necessary to keep the patient dry and comfortable and to avoid irritation of the skin around the incision. The nursing care plan of a patient with either a T-tube or a Y-tube should take into account three major potential problems: infection, obstruction, and dislodgment of the tube. Monitoring for infection includes watching for elevation of body temperature above 100° F and inspection of the tube insertion site for redness, swelling, warmth, and purulent drainage. The patient also is watched for jaundice and complaints of pain in the right upper quadrant, drainage around the tube when it is clamped, nausea, vomiting, and very dark urine and clay-colored stools, all of which indicate obstruction of the common bile duct. The amount of drainage from the tube is measured and recorded at least once every eight hours. A marked decrease in amount could mean that the tube has become dislodged. Biliary tract disease continues to occur in approximately 5 to 8 per cent of all postcholecystectomy patients.

The symptoms can appear within weeks after surgery or may occur years later and are the result of residual stones not removed at the time of surgery, newly formed gallstones, or stricture of the common bile duct. Infections and malignancies also can produce the symptoms of postcholecystectomy syndrome (PCS). Because of hormonal influences, women in the 40- to 49-year-old age group account for almost 80 per cent of patients with PCS. Treatment of the condition varies, but might entail more extensive surgery to provide a means by which bile can drain into the intestines. Placement of T-tube following cholecystectomy. From Monahan et al., 1994. cho·le·cys·tec·to·my (kō'lē-sis-tek'tō-mē), [kō′lisistek′təmē] Etymology: Gk, chole + kystis, bag, ektomē, excision the surgical removal of the gallbladder, performed to treat cholelithiasis, cholecystitis, and gallbladder cancer. Surgery may be delayed while the acute inflammation is treated.

Before surgery an electrocardiogram and tests of hepatic function may be ordered. Under general anesthesia, the gallbladder is excised and the cystic duct ligated, the common duct is explored, and any stones found are removed. The most common complication is disruption of the hepatic or other ducts of the biliary system, requiring surgical correction. Wound infection, hemorrhage, bile leakage, and jaundice may also occur. When possible, cholecystectomy is done as a laparoscopic procedure. See also cholecystitis , cholelithiasis . cholecystectomy Surgery The surgical removal of the gallbladder Indications Gallstones, cholecystitis, cancer. See Bile , Cholecystitis , Gallstones, Laparoscopic cholecystectomy . cho·le·cys·tec·to·my (kō'lĕ-sis-tek'tŏ-mē) (kō″lĕ-sis″tek′tŏ-mē) [ cholecyst- + -ectomy] LAPAROSCOPIC CHOLECYSTECTOMY SCARS Removal of the gallbladder by laparoscopic or abdominal surgery.

The procedure is performed for symptomatic gallbladder and bile duct disease. In the U.S. alone, more than half a million operations are performed annually, but some hospitals have reported a 20% increase in this number since the introduction of laparoscopic surgery. Surgical complications, including wound infections, adverse reactions to anesthetics, and injury to the liver, gallbladder, bile ducts, or neighboring organs, occur about 5% of the time. See: illustration Acute, chronic, or acalculous cholecystitis (biliary inflammation that is not caused by gallstones), repeated episodes of biliary colic, biliary dyskinesia, gallstone pancreatitis, and occasionally cholangitis are indications for the procedure. The gallbladder does not usually need to be removed for asymptomatic gallstone disease. Patient care Preoperative: The patient is informed about the procedure, including the need for drains, catheter, nasogastric tubes, etc., and taught about incentive spirometry, leg exercises, incision splinting, analgesia use, and other postoperative concerns. Postoperative: General patient care concerns apply. Vital signs are monitored and dressings are inspected.

The patient is assessed for pain and for gastrointestinal and urinary function; analgesics and antiemetics are provided as needed. Fluid and electrolyte balance is monitored, and prescribed fluid replacement therapy is administered until the patient is permitted oral intake. The patient is encouraged to breathe deeply and to perform incentive spirometry to prevent atelectasis and impaired gas exchange. The patient is assisted with early ambulation and with splinting the abdomen when moving about or coughing. Peripheral circulation is evaluated, and venous return is promoted with leg exercises and elastic stockings or pneumatic hose as prescribed. If a laparoscopic approach is used, the patient will typically be discharged the day of or the day after surgery. Clear liquids are offered after recovery from general anesthesia, and the patient resumes a normal diet within a few days. If an open incision is used, the patient is placed in a position of comfort; a nasogastric (NG) tube is frequently required to prevent abdominal distention and ileus, and is attached to low intermittent suction; and the volume and characteristics of drainage from the NG tube and any abdominal drains or T-tube are documented. Skin care and appropriate dressings are provided around any drain site.

When peristalsis returns, the NG tube is removed as directed. Oral intake, beginning with clear liquids, is initiated. The T-tube may be clamped before and after each meal to allow additional bile to enter the intestine. Signs and symptoms of postcholecystectomy syndrome (fever, abdominal pain, and jaundice) and other complications involving obstructed bile drainage are reported; urine and stool samples are collected for analysis of bile content should any such complications occur. Discharge teaching for the patient and family includes wound care and T-tube care if appropriate (the T-tube may remain in place up to 2 weeks); the need to report any signs of biliary obstruction (fever, jaundice, pruritus, pain, dark urine, and clay-colored stools); the importance of daily exercise such as walking; avoidance of heavy lifting or straining for the prescribed period; and any restrictions on motor vehicle operation. Although diet is not restricted, the patient may be more comfortable avoiding excessive intake of fats and gas-forming foods for 4 to 6 weeks. Arrangements for home health follow-up or care may be necessary. The patient should return to the surgeon for a post-operative evaluation visit as scheduled.

If gallstones were present, the patient is taught to reduce the risk of recurrence by maintaining normal body weight, exercising regularly, and eating three well-balanced meals daily, including fiber and calcium and avoiding alcohol and foods high in saturated fat. Weight loss, if needed, should be carried out gradually, and crash dieting discouraged. extended cholecystectomy Surgery for gallbladder cancer in which the organ and surrounding tissues (the neighboring liver and regional lymph nodes) are removed. laparoscopic laser cholecystectomy Removal of the gallbladder using a laser as a cutting tool, applied laparoscopically. This procedure may be inappropriate for patients with severe acute cholecystitis, a palpable gallbladder, or evidence of a stone in the common bile duct. The use of a laser as opposed to endoscopic electrosurgical instrument is according to the preference of the surgeon. Patient care The nurse or surgeon explains to the patient that this type of surgery will not be used if the patient is pregnant or has had extensive abdominal surgery (because of concern for adhesions), severe acute cholecystitis, a palpable gallbladder, evidence of a stone in the common bile duct, or a bleeding problem.

The patient is also told that the surgeon, using the endoscopic technique, will be able to remove the gallbladder without unsightly scarring, leaving only four (or less) small punctures, which reduces the risk for wound complications (infection, hematoma, separation). Risks for other complications (pneumonia, thrombophlebitis, urinary retention, and paralytic ileus) are also decreased because the procedure enables early mobility and may avoid use of parenteral analgesia. Patients will experience less pain and immobility, require less narcotic analgesia, be discharged on the same or on the next day, and be able to return to their usual activities (including work) within 7 days. Preoperative preparation, which usually is similar to that for any other abdominal surgery, is explained. Postoperatively, the patient is stabilized during a brief stay in postanesthesia and then is transported to a surgical observation unit. The patient is offered clear liquids (carbonated beverages are avoided because they may cause distension and abdominal pressure). If the patient tolerates liquids, the IV is removed, and the patient is offered a regular diet.

Analgesics are administered orally as prescribed as soon as the patient can take liquids. A parenteral narcotic (which may cause drowsiness, reduced intestinal motility, and/or vomiting) is given only if the patient continues to feel pain after taking an analgesic. Once the patient is comfortable, he is helped to walk because early ambulation speeds recovery. The patient is usually fully awake and walking within 3 or 4 hr of arrival on the unit. If he experiences shoulder pain, a heating pad may be applied. The surgeon, however, usually removes the carbon dioxide at the end of the procedure to prevent this problem. The nurse evaluates the patient's readiness for discharge, which usually can occur if the patient is afebrile, walking, eating, and voiding, and has stable vital signs with no evidence of bleeding or bile leakage. To assess for the latter risks, the patient is observed for severe pain and tenderness in the right upper quadrant, an increase in abdominal girth, leakage of bile-colored drainage from the puncture site, a fall in blood pressure, and increased heart rate The patient is instructed to keep the adhesive bandages covering the puncture site clean and dry.

He may remove them the next day and bathe or shower as usual. The patient most likely will require little analgesia, but a prescription is given for use as needed. He is reminded to pace activity according to energy level. While no special diet is required, the patient may wish to avoid excessive fat intake and gas-forming foods for 4 to 6 weeks. He should return to the surgeon for follow-up evaluation as directed and report any vomiting, abdominal distention, signs of infection, and new or worsening pain. illustration Surgical removal of the gall bladder. cholecystectomy Gallbladder removal - NHS Choices Gallbladder removal Introduction Gallbladder removal surgery, also known as a cholecystectomy, is a very common procedure. The gallbladder is a small, pouch-like organ in the upper right part of your tummy. It stores bile, a fluid produced by the liver that helps break down fatty foods. You don't need a gallbladder, so surgery to take it out is often recommended if you develop any problems with it. Why does my gallbladder need to be removed? Surgery to remove the gallbladder is usually carried out if you have painful gallstones .

These are small stones that can form in the gallbladder as a result of an imbalance in the substances that make up bile. Gallstones often cause no symptoms and you may not realise you have them, but occasionally they can block the flow of bile and irritate the gallbladder ( acute cholecystitis ) or pancreas ( acute pancreatitis ). This can cause symptoms such as: sudden and intense tummy pain feeling and being sick yellowing of the skin and the whites of the eyes ( jaundice ) Very occasionally it may be possible to take tablets to dissolve gallstones, but surgery to remove the gallbladder is the most effective treatment in the vast majority of cases.

What happens during gallbladder removal surgery There are two main ways of removing a gallbladder: laparoscopic (keyhole) cholecystectomy – several small cuts (incisions) are made in your tummy (abdomen) and fine surgical instruments are used to access and remove your gallbladder open cholecystectomy – a single, larger incision is made in your tummy to access and remove your gallbladder Keyhole surgery is used most often because you can leave hospital sooner, recover faster and are left with smaller scars than with an open procedure. Both techniques are performed under general anaesthetic , which means you'll be asleep during the operation and won't feel any pain while it's carried out. Recovering from gallbladder removal surgery It doesn't usually take long to recover from keyhole surgery to remove your gallbladder. Most people can leave hospital the same day or the next morning. You'll probably be able to return to most of your normal activities within two weeks. It takes longer to recover from open surgery. You may need to stay in hospital for three to five days and it could be six to eight weeks before you're feeling back to normal.

Living without a gallbladder You can lead a perfectly normal life without a gallbladder. Your liver will still make enough bile to digest your food but, instead of being stored in the gallbladder, it drips continuously into your digestive system. You may have been advised to eat a special diet before surgery, but this doesn't need to be continued afterwards. Instead, you should aim to have a generally healthy, balanced diet . Some people experience problems such as bloating or diarrhoea after surgery, although this usually improves within a few weeks. If you notice certain foods or drinks trigger these symptoms, you may wish to avoid them in the future. Read more about your diet after gallbladder surgery . Risks of gallbladder removal surgery Gallbladder removal surgery is considered to be a safe procedure, but like any type of surgery there is a risk of complications. Possible complications include: bile leaking into the tummy damage to one of the openings (ducts) carrying bile out of the liver Why it's done - Cholecystectomy (gallbladder removal) - Mayo Clinic Cholecystectomy (gallbladder removal) A cholecystectomy is most commonly performed to treat gallstones and the complications they cause.

Your doctor may recommend a cholecystectomy if you have: Gallstones in the gallbladder (cholelithiasis) Gallstones in the bile duct (choledocholithiasis) Gallbladder inflammation (cholecystitis) Gallstones. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed June 15, 2016. Understanding gallstones. American Gastroenterological Association. Accessed June 15, 2016. Feldman M, et al. Gallstone disease. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. Accessed June 16, 2016. Patient information for laparoscopic gall bladder removal (cholecystectomy) from SAGES. Society of American Gastrointestinal and Endoscopic Surgeons. Accessed June 15, 2016. Feldman M, et al. Gallstone disease. In: Sleisenger and Fordtran's Gastrointestinal Cholecystectomy. American College of Surgeons.

Accessed June 15, 2016. Picco MF (expert opinion). Mayo Clinic, Rochester, Minn. June 22, 2016. Related Cholecystectomy, laparoscopic - Surgery | BMI Healthcare UK BMI Healthcare UK Serious about health. Passionate about care. Search… hospitals What is a cholecystectomy? A laparoscopic cholecystectomy involves the surgical removal of the gall bladder. This is usually recommended when gallstones have formed and are causing health complications (such as abdominal pain). What are gallstones? Gallstones are ‘stones’ that form in the gallbladder. They are quite common but increase with age and in people who eat a diet rich in fat. In some people, gallstones can cause severe symptoms with repeated attacks of abdominal pain being the most common. (see fig.1) What are the benefits of surgery? You should be free of pain and able to eat a normal diet. Surgery should also prevent the serious complications that gallstones can cause. Are there any alternatives to surgery?

It is possible to dissolve the stones or even shatter them into small pieces but these techniques involve unpleasant drugs and side effects, have a high failure rate and the gallstones usually come back. Antibiotics can be used to treat any infections of the gallbladder. A low-fat diet may help to prevent attacks of pain. However, symptoms are likely to come back. What does the operation involve? The operation is performed under a general anaesthetic and usually takes about an hour. The laparoscopic (‘keyhole’) technique is usually used. Your surgeon will make several small cuts on your abdomen. They will place surgical instruments, along with a telescope, inside your abdomen and perform the operation. Your surgeon will free up the gallbladder duct (cystic duct) and artery. They will then separate the gallbladder from the liver and remove it. What complications can happen? General complications of any operation: Pain Infection in the surgical wound Unsightly scarring Specific complications of this operation: a. Laparoscopic complications Developing a hernia near one of the cuts Surgical emphysema Leaking of bile or stones Retained stones Serious damage to the liver How soon will I recover?

You should be able to go home later on the same day. You should be able to return to work after two to four weeks but this may vary depending on the extent of surgery and your type of work. Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, you should ask a member of the healthcare team or your GP for advice. You should make a full recovery and be able to eat a normal diet. Laparoscopic cholecystectomy summary Gallstones are a common problem. An operation to remove your gallbladder should result in you being free of pain and able to eat a normal diet. Surgery should also prevent the serious complications that gallstones can cause. Paying for your operation Laparoscopic cholecystectomy costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment the cost of the operation will be explained and confirmed in writing when you book the operation. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure. Acknowledgements Author: Mr Simon Parsons DM FRCS (Gen.

Surg.) Illustrations: Hannah Ravenscroft RM This document is intended for information purposes only and should not replace advice that your relevant health professional would give you. Copyright © 2008 EIDO Healthcare Limited The operation and treatment information on this website is produced by EIDO Healthcare Ltd and is licensed by BMI Healthcare. The intellectual property rights to the information belong exclusively to EIDO Healthcare Limited. You may not copy, print out, download or otherwise reproduce any of the information other than for your personal, non-commercial use. The information should not replace advice that your relevant health professional would give you. Pricing Cholecystectomy - Health Encyclopedia - University of Rochester Medical Center What is a cholecystectomy? A cholecystectomy is surgery to remove your gallbladder. The gallbladder is a small organ under your liver. It is on the upper right side of your belly or abdomen. The gallbladder stores a digestive juice called bile which is made in the liver. There are 2 types of surgery to remove the gallbladder: Open (traditional) method. In this method, 1 cut (incision) about 4 to 6 inches long is made in the upper right-hand side of your belly.

The surgeon finds the gallbladder and takes it out through the incision. Laparoscopic method. This method uses 3 to 4 very small incisions. It uses a long, thin tube called a laparoscope. The tube has a tiny video camera and surgical tools. The tube, camera and tools are put in through the incisions. The surgeon does the surgery while looking at a TV monitor. The gallbladder is removed through 1 of the incisions. A laparoscopic cholecystectomy is less invasive. That means it uses very small incisions in your belly. There is less bleeding. The recovery time is usually shorter than an open surgery. In some cases the laparoscope may show that your gallbladder is very diseased. Or it may show other problems. Then the surgeon may have to use an open surgery method to remove your gallbladder safely. Why might I need a cholecystectomy?

A cholecystectomy may be done if your gallbladder: Has lumps of solid material (gallstones) Is red or swollen (inflamed), or infected (cholecystitis) Is cancerous Gallbladder problems may cause pain which: Is usually on the right side or middle of your upper belly May be constant or may get worse after a heavy meal May sometimes feel more like fullness than pain May be felt in your back and in the tip of your right shoulder blade Other symptoms may include nausea, vomiting, fever, and chills. The symptoms of gallbladder problems may look like other health problems. Always see your healthcare provider to be sure. Your healthcare provider may have other reasons to recommend a cholecystectomy. What are the risks of a cholecystectomy? Some possible complications of a cholecystectomy may include: Bleeding Infection Injury to the tube (the bile duct) that carries bile from the gallbladder to the small intestine Liver injury Scars and a numb feeling at the incision site A bulging of organ or tissue (a hernia) at the incision site During a laparoscopic procedure, surgical tools are put into your belly. This may hurt your intestines or blood vessels.

You may have other risks that are unique to you. Be sure to discuss any concerns with your healthcare provider before the procedure. How do I get ready for a cholecystectomy? Your healthcare provider will explain the procedure to you. Ask him or her any questions you have. You may be asked to sign a consent form that gives permission for the procedure. Read the form carefully and ask questions if anything is not clear. Your provider will ask questions about your past health. He or she may also give you a physical exam. This is to make sure you are in good health before the procedure. You may also need blood tests and other diagnostic tests. You must not eat or drink for 8 hours before the procedure. This often means no food or drink after midnight. Tell your provider if you are pregnant or think you may be pregnant. Tell your provider if you are sensitive to or allergic to any medicines, latex, tape, and anesthesia medicines (local and general). Tell your provider about all the medicines you take. This includes both over-the-counter and prescription medicines. It also includes vitamins, herbs, and other supplements. Tell your provider if you have a history of bleeding disorders.

Let your provider know if you are taking any blood-thinning medicines, aspirin, ibuprofen, or other medicines that affect blood clotting. You may need to stop taking these medicines before the procedure. If this is an outpatient procedure, you will need to have someone drive you home afterward. You won’t be able to drive because of the medicine given to relax you before and during the procedure. Follow any other instructions your provider gives you to get ready. What happens during a cholecystectomy? You may have a cholecystectomy as an outpatient or as part of your stay in a hospital. The way the surgery is done may vary depending on your condition and your healthcare provider's practices. A cholecystectomy is generally done while you are given medicines to put you into a deep sleep (under general anesthesia). Generally, a cholecystectomy follows this process: You will be asked to take off any jewelry or other objects that might interfere during surgery. You will be asked to remove clothing and be given a gown to wear. An intravenous (IV) line will be put in your arm or hand. You will be placed on your back on the operating table. The anesthesia will be started.

A tube will be put down your throat to help you breathe. The anesthesiologist will check your heart rate, blood pressure, breathing, and blood oxygen level during the surgery. If there is a lot of hair at the surgical site, it may be clipped off. The skin over the surgical site will be cleaned with a sterile (antiseptic) solution. Open method cholecystectomy An incision will be made. The incision may slant under your ribs on the right side of your abdomen. Or it may be made in the upper part of your abdomen. Your gallbladder is removed. In some cases, 1 or more drains may be put into the incision. This allows drainage of fluids or pus. Laparoscopic method cholecystectomy About 3 or 4 small incisions will be made in your abdomen. Carbon dioxide gas will be put into your abdomen so that it swells up. This lets the gallbladder and nearby organs be easily seen. The laparoscope will be put into an incision. Surgical tools will be put through the other incisions to remove your gallbladder. When the surgery is done, the laparoscope and tools are removed.

The carbon dioxide gas is let out through the incisions. Most of it will be reabsorbed by your body. Procedure completion, both methods The gallbladder will be sent to a lab for testing The incisions will be closed with stitches or surgical staples A sterile bandage or dressing or adhesive strips will be used to cover the wounds What happens after a cholecystectomy? In the hospital After the procedure, you will be taken to the recovery room to be watched. Your recovery process will depend on the type of surgery and the type of anesthesia you had. Once your blood pressure, pulse, and breathing are stable and you are awake and alert, you will be taken to your hospital room. A laparoscopic cholecystectomy may be done on an outpatient basis. In this case, you may be discharged home from the recovery room. You will get pain medicine as needed. A nurse may give it to you. Or you may give it to yourself through a device connected to your IV (intravenous) line. You may have a thin plastic tube that goes through your nose into your stomach. This is to remove air that you swallow. The tube will be taken out when your bowels are working normally.

You won’t be able to eat or drink until the tube is removed. You may have 1 or more drains in the incision if an open procedure was done. The drains will be removed in a day or so. You might be discharged with the drain still in and covered with a dressing. Follow your provider’s instructions for taking care of it. You will be asked to get out of bed a few hours after a laparoscopic procedure or by the next day after an open procedure. Depending on your situation, you may be given liquids to drink a few hours after surgery. You will slowly be able to eat more solid foods as tolerated. Arrangements will be made for a follow-up visit with your provider. This is usually 2 to 3 weeks after surgery. At home Once you are home, it’s important to keep the incision clean and dry. Your provider will give you specific bathing instructions. If stitches or surgical staples are used, they will be removed during a follow-up office visit. If adhesive strips are used, they should be kept dry and usually will fall off within a few days. The incision and your abdominal muscles may ache, especially after long periods of standing.

If you had a laparoscopic surgery, you may feel pain from any carbon dioxide gas still in your belly. This pain may last for a few days. It should feel a bit better each day. Take a pain reliever as recommended by your provider. Aspirin or other pain medicines may raise your risk of bleeding. Be sure to take only medicines your healthcare provider has approved. Walking and limited movement are generally fine. But you should avoid strenuous activity. Your provider will tell you when you can return to work and go back to normal activities. Call your provider if you have any of the following: Fever or chills Redness, swelling, bleeding, or other drainage from the incision site More pain around the incision site Yellowing of your skin or the whites of your eyes (jaundice) Belly or abdominal pain, cramping, or swelling No bowel movement or gas for 3 days Pain behind your breastbone

Question: What is surgically removed if you have a cholecystectomy?
Answer: Gall Bladder